Gray Matter Structural Network Disruptions in Survivors of Acute Lymphoblastic Leukemia with Chemotherapy Treatment.

OBJECTIVES: Neuroimaging studies of acute lymphoblastic leukemia (ALL) during chemotherapy treatment have shown alterations in structure, function, and connectivity in several brain regions, suggesting neurobiological impairment that might influence the large-scale brain network. This study aimed to detect the alterations in the topological organization of structural covariance networks of ALL patients. METHODS: This study included 28 ALL patients undergoing chemotherapy and 20 matched healthy controls. We calculated the gray matter volume of 90 brain regions based on an automated anatomical labeling template and applied graph theoretical analysis to compare the topological parameters of the gray matter structural networks between the two groups. RESULTS: The results demonstrated that both the ALL and healthy control groups exhibited a small-world topology across the range of densities. Compared to healthy controls, ALL patients had less highly interactive nodes and a reduced degree/betweenness in temporal regions, which may contribute to impaired memory and executive functions in these patients. CONCLUSION: These results reveal that ALL patients undergoing chemotherapy treatment may have decreased regional connectivity and reduced efficiency of their structural covariance network. This is the first report of anomalous large-scale gray matter structural networks in ALL patients undergoing chemotherapy treatment and provides new insights regarding the neurobiological mechanisms underlying the chemo-brain network.

Altered brain structural and cognitive impairment in end-stage renal disease patients with secondary hyperparathyroidism.

BACKGROUND: Cognitive impairment has received attention as an important problem in patients with end-stage renal disease, although end-stage renal disease patients with secondary hyperparathyroidism have not been studied. PURPOSE: To assess the pattern of brain volume changes in end-stage renal disease patients with secondary hyperparathyroidism by using voxel-based morphometry and correlating these measures with clinical markers and the Montreal Cognitive Assessment scores. MATERIAL AND METHODS: Fifty end-stage renal disease patients with no anatomical abnormalities in conventional MRI (25 patients with secondary hyperparathyroidism, 14 men, mean age 42.20 ± 7.53 years; 25 patients without secondary hyperparathyroidism, 15 men, mean age 41.96 ± 6.17 years) were selected in this study. All patients underwent laboratory tests, neuropsychological tests, and MRI. Voxel-based morphometry analysis was performed to detect regional gray matter volume differences between the two groups. The relationships between abnormal gray matter volume and clinical markers and Montreal Cognitive Assessment scores were investigated. RESULTS: Voxel-based morphometry revealed increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism in the bilateral caudate and bilateral thalamus compared with non- secondary hyperparathyroidism end-stage renal disease patients (P < 0.05, FWE corrected). Regarding the laboratory and neuropsychological tests, we found significant correlations between volume in these brain regions and intact parathyroid hormone levels and negative correlations with the Montreal Cognitive Assessment scores. There were no significant associations between brain volume changes and other clinical data (disease duration, urea, creatinine, and uric acid levels). CONCLUSION: Our results showed significantly increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism, which was associated with intact parathyroid hormone levels and cognitive impairment. Serum intact parathyroid hormone levels may be a risk factor for cognitive impairment in end-stage renal disease patients with secondary hyperparathyroidism.

Solitary fibrous tumor of the seminal vesicle: A case report.

RATIONALE: Solitary fibrous tumor (SFT) is an unusual neoplasm, especially when it originates from the seminal vesicle. Herein, we describe a case of SFT that arises from the seminal vesicle. PATIENT CONCERNS: A 66-year-old man presented to our hospital complaining of a huge irregular tumor in his pelvis during a health checkup. He was worried that the tumor could be a malignant tumor and hence wanted to undergo further examination and therapy. DIAGNOSIS: An inhomogeneous, mixed soft tissue tumor in the pelvis was found during computed tomography (CT) and magnetic resonance imaging. The tumor showed heterogeneous and delayed enhancement during contrast-enhanced CT. The tumor was diagnosed as a cystadenoma originated from the seminal vesicle due to its imaging features. But the pathological diagnosis was SFT that originated from the seminal vesicle. INTERVENTIONS: Laparoscopic seminal vesicle tumor resection was performed. OUTCOMES: There was no evidence of recurrence at the 6-month follow-up. LESSONS: SFT in the seminal vesicle is extremely rare. It is very difficult to distinguish SFT in the seminal vesicle from the primary tumors as both have similar imaging features. We describe the tumor with SFT being considered as a differential diagnosis when the tumor is found in the seminal vesicle.